Negative Caregiving Effects Among Caregivers of Veterans With Dementia
Negative Caregiving Effects Among Caregivers of Veterans With Dementia
复制标题
DOI：
10.1097/jgp.0b013e31824108ca
复制
发表时间：
2012-03-01
影响因子：
7.2
通讯作者：
Kunik, Mark E.
中科院分区：
文献类型：
--
作者：
Bass, David M.;Judge, Katherine S.;Kunik, Mark E.
目的：这项调查的指导下的压力过程模型，有两个目标：第一，描述的程度，负向抑郁症的退伍军人的家庭照顾者，第二，确定显着的预测负向抑郁症的影响。设计图：数据来自基线，结构化电话采访参加“痴呆症护理合作伙伴”的退伍军人的家庭照顾者，这是一项测试护理协调干预的临床试验。参会人员：该研究包括486名患有痴呆症的退伍军人的家庭照顾者，他们接受退伍军人事务部医疗保健系统的初级护理并住在家里。测量：六个负面的影响被描述如下：未满足的需求，四个角色和内在的压力，和抑郁症。预测因素包括：认知功能障碍，行为问题，个人护理依赖，慢性疾病的数量，以及生活环境的特点。结果：照顾者的相当大的部分经历了负面的影响，最常见的是未满足的需求，社会孤立和抑郁症。痴呆症和其他共存慢性疾病的认知、行为和功能症状解释了所有负面影响的显著变化。照顾环境的影响不大。行为问题是最一致的预测因素;个人护理依赖和其他慢性疾病也很重要。结论：家庭照顾者，长期照顾住在家里的痴呆症退伍军人的基础，经历了各种负面的影响。当退伍军人表现出行为问题时，负面影响更大，需要广泛的个人护理援助，并且有更多的共存慢性疾病。消极的家庭影响是支持家庭照顾者和促进家庭持续照顾的干预措施的一个重要目标。(Am J Geriatr Psychiatry 2012; 20：239-247）
Objectives: This investigation was guided by the stress process model and had two objectives: first, to describe the extent of negative caregiving effects for family caregivers of veterans with dementia, and second, to identify salient predictors of negative caregiving effects. Design: Data were obtained from baseline, structured telephone interviews with family caregivers of veterans enrolled in "Partners in Dementia Care," a clinical trial testing a care coordination intervention. Participants: The study included 486 family caregivers of veterans with dementia who received primary care from the Department of Veterans Affairs healthcare system and lived at home. Measurement: Six negative caregiving effects were described as follows: unmet needs, four role and intrapsychic strains, and depression. Predictive factors included the following: cognitive impairment, behavior problems, personal care dependency, number of chronic conditions, and characteristics of the caregiving context. Results: Sizeable portions of caregivers experienced negative caregiving effects; most common were unmet needs, social isolation, and depression. Cognitive, behavioral, and functional symptoms of dementia and other coexisting chronic conditions explained significant variation in all negative caregiving effects. Caregiving context had little impact. Behavior problems were the most consistent predictor; personal care dependency and other chronic conditions were also important. Conclusions: Family caregivers, the foundation of long-term care for veterans with dementia who live at home, experience a variety of negative caregiving effects. Negative effects are greater when veterans exhibit behavior problems, require extensive assistance with personal care, and have a greater number of coexisting chronic conditions. Negative caregiving effects are an important target for interventions that support family caregivers and promote continued care at home. (Am J Geriatr Psychiatry 2012; 20:239-247)